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GIFT   OF 

Pacific    Coast 

Jfrnrnnl    nf  NiTPfi'iTt^ 


Handbook  of 

Organizcttion   and  Method  in 

Hospital  Social  Service 


Handbook  of 

Organizdtion  and  •  Method  in 

Hospital  So'cidl  Sewice 


An  Outline  of  Policies  as  practiced  at 

The  Johns  Hopkins  Hospital 

Baltimore,  Md. 


by 


MARGARET  S.  BROGDEN 

Chief  of  Social  Service 

The  Johns  Hopkins  Hospital 

Baltimore,  Md. 


THE  NORMAN,  REMINGTON  CO. 

PUBLISHERS, 
BALTIMORE,  MD. 


-RA^ 


^t 


GIFT  PAOIFIC  COAST   JOURNAL 
OF    NUBdING  to  HYG£1NE-   DEPT., 


Copyright,  1922,  by 
The  Norman,  Remington  Co. 


Published  June,  1922 


Printed  in  the  United  States  of  America  at  the  Press  of  G.  A.  Peters  Co.,  Baltimore. 


IN  THE  HOSPITAL 

The  doctor  smiled,  and  said,  "You  may  go  home 

Tomorrow;"  and  he  looked  surprised  when  I 

Returned  no  answering  smile.    How  should  he  know 

The  sudden  shrinking  of  my  tortured  flesh 

From  all  that  ''going  Home"  implies  to  me? 

I  am  so  tired — so  tired !    And  when  I  think 

Of  taking  up  the  burdens  that  I  dropped 

When  sickness  bought  for  me  a  breathing  space — 

The  grimy,  odorous  clothes,  so  hard  to  rub 

To  whiteness  as  I  bend  above  the  suds; 

The  food  that  must  be  bought,  prepared,  and  cooked; 

The  constant  struggle  to  keep  up  the  rent, 

So  that  our  poor,  cheap  sticks  of  furniture 

May  not  be  set  out  in  the  public  street, 

(Ah,  God!  that  fear  looms  chief  of  all  my  fears!) — 

Then  is  it  strange  that  I  should  weakly  cling 

To  this  white  cot,  this  atmosphere  of  rest. 

Where  I  may  sleep,  afar  from  vendors'  cries, 

And  noisy  brawlings  from  the  flat  next  door? 

I  almost  hoped  this  pain  would  end  all  pain; 

But  no;  the  verdict's  ''Life!"   I  must  "go  home!" 

— Florence  Van  Cleve. 


7435 1 8 


INTRODUCTION 


Monrovia,  California, 
May  17,  1922. 

"Miss  Margaret  S.  Brogden, 
Social  Service  Department, 
The  Johns  Hopkins  Hospital, 
Baltimore,  Maryland. 

My  dear  Miss  Brogden: 

Your  letter  was  forwarded  to  me  here,  where  I 
am  spending  the  summer. 

I  used  your  Policy  Book  as  reference  material 
for  those  students  in  my  course  in  record  keeping  who 
were  interested  particularly  in  hospital  social  service, 
and  to  that  group  I  feel  that  it  had  real  value  in 
making  clear  the  relationship  of  records  to  hospital 
administration,  and  of  showing  case  records  in  their 
administrative  setting,  a  thing  which  the  new  worker 
always  needs  to  learn. 

Of  course,  it  is  understood  that  adaptations 
would  be  needed  in  applying  this  or  any  other  plan 
to  another  institution,  but  it  seems  to  me  that  any 
hospital  social  service  worker  would  be  helped  by  the 
suggestions  in  this  book. 

Sincerely  yours 
(Signed)  GEORGIA  G.  RALPH." 

(Of  the  New  York  School  of  Social  Work). 


PREFACE 

With  the  growth  and  development  of  the  social 
service  department,  the  need  of  a  reference  book 
setting  forth  clearly  the  routine  and  policies  of  the 
department,  accessible  to  all  the  workers,  became 
apparent. 

To  meet  such  need  this  book  was  compiled. 

In  addition  to  our  own  routine  and  policies  I  have 
incorporated  into  it  helpful  material  and  sugges- 
tions from  the  Boston  Dispensary  and  the  Massachu- 
setts General  Hospital  Social  Service  Departments, 
the  writings  of  Miss  Mary  E.  Richmond,  Dr.  Richard 
C.  Cabot  and  others,  to  whom  I  am  much  indebted 
for  their  co-operation  and  courtesy. 

This  book  was  compiled  with  no  idea  of  publica- 
tion. It  is  being  published  now  in  response  to  numer- 
ous requests  from  visitors  to  our  department.  The 
original  is  in  the  form  of  a  loose-leaf  ledger,  and  has 
been  revised  from  time  to  time  to  meet  changes  in  the 
social  service  department  or  dispensary  routine.  I 
regret  that  at  this  late  date  I  can  not  give  due  recog- 
nition to  those  who  have  generously  helped  me  with 
their  suggestions  and  material. 

M.  S.  B. 


TABLE   OF   CONTENTS 


Page 

Diagram facing  13 

Organization  of  the  Hospital 13 

Report  of  Committee  on  the  Function  of  Hospi- 
tal Social  Work 18 

Approach  to  Doctors  and  Nurses 19 

Case  Analysis 21- 

Case  Work 22 

Records: 

Attitude  toward  Records 30 

The  Danger  of  Becoming  Mechanical  in  Work  30 
The  Need  of  Accuracy  and  Completeness  of 

Information 31 

The  Need  of  Getting  Results 32 

Records  Should  Show 32 

Types  of  Records 33 

Statistical  Records 33 

Intensive  and  Short  Service  Case  Records 33 

Yellow  Sheet 34 

Old  Histories 34 

Letters 35 

Making  Corrections  in  Typewritten  Work 35 

Folders 35 

Care  of  Records 35 

Outline  for  Writing  Histories 37 

Outline  for  Yellow  Sheet 40 

Forms 41 

Use  of  Medical  Records 49 

Registration  of  Cases 51 

Cards 51 


Statistics:  Page 

Monthly  Sheets 55 

Transferred  Cases 55 

Closed  Cases 55 

Forms 56 

Confidential  Exchange  of  Information: 

Principles  of  Confidential  Exchange  of  Infor- 
mation   60 

Registration  of  Cases 60 

Form 61 

Giving  Information  to  Outside  Agencies  and 

Individuals 62 

Steering  Blanks 62 

Bills,  Orders  and  Money: 

Ledger  Cards 63 

Orders 64 

Instalments: 

Method  of  Payments 66 

Method  of  Closing  Cases 67 

Requests  for  Free  Treatment 67 

Miscellaneous  Forms: 

Refemng  Patients  to  Social  Service :...  68 

Discharge  Notice  to  Social  Service 68 

Form  given  by    Interne    to    Patients   upon 

Discharge 69 

Supplies: 

General  Office 69 

Departments 70 

Repairs 70 

Outside  Requisitions 70 


Office  Rules:  Page 

Volunteer 72 

Telephone 72 

Telegrams 74 

Filing 74 

Keys 74 

In  and  Out  Board 74 

Office  Resources 74 

Use  of  the  Social  Service  Ford 75 

Clothing  required  by  the  Patients  entering 
THE  State  Tuberculosis ;JSanatorium 76 

Key  to  Abbreviations 77 


THE  JOHNS  HOPKINS  HOSPITAL 

Orfianization  of  the  Social   Service  Department 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE   13 


SOCIAL  SERVICE   DEPARTMENT 

ORGANIZATION  OF  THE  HOSPITAL 

The  Johns  Hopkins  is  a  general  hospital  of  625  beds. 

The  service  includes: 

Medicine,  with  sub-divisions, 

Surgery,  with  sub-divisions. 

Gynecology,  with  sub-divisions. 

Obstetrics, 

Pediatrics, 

Psychiatry, 

Pathology, 

X-Ray, 

Social  Service, 

Out-Patient  Department. 

There  is  a  daily  dispensary  service,  with  nineteen 
departments,  and  an  average  attendance  of  475 
patients  a  day. 

Each  hospital  service  has  a  chief  of  service,  with 
resident  and  visiting  staff. 


14  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

There  is  a  Training  School  for  Nurses,  with  48 
officers  and  240  pupils.   The  course  is  three  years. 

Social  Service  is  an  integral  department  of  the 
hospital,  supported  by  hospital  funds.  The  staff 
comprises  a  department  chief  and  sixteen  associates. 
The  department  chief  is  responsible  to  the  trustees 
through  the  director  of  the  hospital.  Social  Service 
is  in  operation  in  the  following  services: 

Department  of  Medicine, 
Surgery, 
Pediatrics, 
Psychiatry, 
Tuberculosis, 
Syphology, 
Ophthalmology, 
Orthopedics, 
General. 

The  social  workers  are  assigned  to  a  definite  service 
and  cases  are  referred  by  the  physicians  on  that  ser- 
vice from  both  the  hospital  wards  and  out-patient 
department. 

A  weekly  staff  meeting  is  held  on  Thursday,  9-10 
A.M. 

The  function  of  the  social  worker  is  to  aid  in  medi- 
cal treatment  and  prevention  of  disease  through  in- 
vestigation, reporting  to  the  physician  and  adjustment 
of  problems,  both  personal  and  environmental,  that 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE   15 

hinder  or  retard  the  process  of  recovery.  If  I  may 
define  our  function  in  the  terms  of  the  American  Hos- 
pital Association's  Survey : 

** Discovery  and  reporting  to  the  physician  facts 
regarding  the  patient's  personaUty  and  environment 
which  relate  to  his  physical  condition. 

Overcoming  obstacles  to  successful  treatment, 
such  as  may  exist  or  arise  in  his  home  or  work. 

Assisting  the  physicians  by  arranging  for  supple- 
mentary care  when  required. 

Educating  the  patient  in  regard  to  his  physical 
condition  in  order  that  he  may  co-operate  to  the  best 
advantage  with  the  doctor's  program  for  the  cure  of 
the  illness,  or  the  promotion  of  health." 

Through  the  Social  Service,  interpreters  are  secured 
for  foreign-speaking  patients.  Aid  in  management  of 
clinic  is  supplied  by  volunteer  staff.  Medical  infor- 
mation and  advice  regarding  medical  sources  is  fur- 
nished outside  agencies.  Such  services  as  arranging 
for  transportation  and  escorting  patients  who  are 
unable  to  perform  these  offices  for  themselves,  either 
because  of  illness  or  ignorance,  are  rendered.  All 
cases  are  referred  by  the  physicians  with  definite 
recommendations. 

The  Johns  Hopkins  is  a  private  hospital  dependent 
for  support  upon  its  endowment,  voluntary  contribu- 
tions and  fees  from  patients.  Both  private  and 
public  ward  patients  are  received.  During  the  year 
from  February  1,  1920,  to  February  1,  1921  7,793 
patients  were  treated  in  the  hospital  wards,  and 


16  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

142,532  visits  were  made  to  the  out-patient  depart- 
ment. 2,882,  or  37.1%  of  the  house  patients,  re- 
ceived free  treatment,  and  2,791,  or  35.8%,  were 
treated  at  a  reduced  rate. 

The  Johns  Hopkins  is  essentially  a  teaching  hos- 
pital, closely  allied  with  the  Johns  Hopkins  Univer- 
sity and  Medical  School.  The  members  of  the  Hos- 
pital Staff  hold  corresponding  positions  in  the  Medical 
School;  for  example  the  Professor  of  Medicine  is  the 
Physician-in-Chief  to  the  hospital  and  the  head  of 
the  Medical  Service. 

Courses  in  psychiatric  and  medical  social  service 
are  given  in  collaboration  with  the  Johns  Hopkins 
University,  to  a  limited  number  of  students  who  have 
completed  the  first  year's  work  in  the  course  in  Social 
Economics  at  the  Johns  Hopkins  University,  or  a 
school  of  social  work  of  equal  requirements. 


^ 


REPORT   OF   COMMITTEE 
ON  THE  FUNCTIONS  OF  HOSPITAL   SOCIAL 

WORK    cx-^ 

Presented  at  the  Annual  Meeting  of  The  American 
Association  of  Hospital  Social  Workers,  June,  1921. 

Permanent  Functions 

1.  Case  work;  by  the  method  of  social  case  work 
to  care  for  ward  patients  and  out-patients  whose 
medical  and  social  condition  indicate  need  of  adjust- 
ment in  order  to  render  their  medical  treatment 
effective  and  restore  them  to  health  and  sound  social 
condition. 

2.  Research;  to  study  social  causes  of  health  con- 
ditions and  behavior. 

3.  Education; 

a.  To  co-operate  with  schools  of  social  work  in 
the  training  of  students  for  hospital  social  work. 

b.  To  give  to  students  from  training  school  for 
nurses,  medical  schools  and  from  schools  of  socio- 
logy and  psychology  insight  into  the  social  environ- 
mental conditions  of  patients,  through  lectures, 
required  reading  and  field  work. 

c.  To  interpret  the  hospital  to  the  community 
by  posters,  charts,  public  speaking  and  other 
means,  and  to  help  to  make  the  resources  of  the 
institution  available  to  persons  in  the  community. 

d.  To  educate  the  public  by  the  same  means  in 
hygiene  and  to  teach  the  relation  between  social 
conditions  and  health. 


18  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

e.  To  co-operate  with  such  outside  agencies, 
institutions  and  interested  individuals  as  may 
serve  to  enlarge  the  functions  of  the  hospital,  and 
to  render  its  care  of  patients  more  effective. 

Temporary  Functions 

In  organizing  a  department,  it  may  be  necessary 
to  undertake,  for  a  time,  certain  duties  that  are  not 
essentially  the  function  of  hospital  social  work,  such 
as  those  of  clinical  clerk,  admitting  clerk,  financial 
investigator  for  the  hospital  or  messenger,  which  may 
be  performed  for  a  time  with  the  intention  of  helping 
the  hospital  to  fulfill  its  obligations  toward  the  com- 
munity as  well  as  to  the  patients.  In  undertaking 
these  temporary  and  supplementary  duties  it  is  im- 
portant not  to  lose  sight  of  the  fact  that  the  primary 
function  of  hospital  social  work  is  social  case  work, 
and  that  the  best  contribution  of  such  work  both  to 
the  hospital  and  the  community  is  to  perform  this 
function. 


"APPROACH  TO  DOCTORS  AND  NURSES" 

"Find  out  the  names  of  doctors  and  nurses  on  duty 
in  the  dinic  before  going  to  it. 

"On  entering  a  clinic  to  take  a  patient  to  a  doctor, 
or  to  make  inquiry,  be  careful  each  time  to  give  your 
name  and  state  your  connection  with  the  dispensary, 
to  wit:  "of  the  social  service  department." 

"DO  NOT  OMIT  the  formality  unless  you  are  sure 
that  your  name  and  connection  are  well  known, 
remembering  that  you  are  but  one  of  many  going  on 
similar  errands  and  that  it  is  not  easy  for  the  doctors 
to  place  each  personality  quickly. 

"In  referring  a  patient  to  a  doctor,  only  give  the 
symptoms  which  led  you  to  seek  medical  advice.  Do 
not  make  a  diagnosis.  For  example:  never  say, 
'I  have  brought  John  to  see  you  about  his  adenoids, 
but  say,  'As  John  can  not  breathe  through  his  nose,  I 
want  him  to  have  an  examination.'  The  making  of 
a  diagnosis  by  a  layman  is  very  irritating  to  a  physi- 
cian, and  therefore  extremely  bad  etiquette.  Doctors 
themselves  in  seeking  a  consultant  are  very  cautious 
about  doing  so. 

"Give  the  physician  sufficient  information  in  regard 
to  your  errand  to  gain  his  interest,  but  do  so  in  as  few 
words  as  possible. 

"When  a  doctor  refers  a  patient  to  a  social  worker, 
or  makes  inquiry  of  a  social  worker  in  regard  to  a 
patient,  if  the  particular  patient  in  question  is  present, 
or  other  patients,  do  not  discuss  the  case  in  their 
presence.  Make  an  excuse  for  seeing  the  doctor  in 
another  room  or  at  another  time. 


20  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

"Before  leaving  the  clinic  make  a  definite  arrange- 
ment at  the  doctor's  convenience  for  securing  a  report 
in  regard  to  the  examination  of  the  patient.  For 
example,  either  plan  to  return  to  the  clinic  at  a  certain 
time  or  to  see  the  doctor  in  the  social  service  depart- 
ment on  his  way  out  of  the  dispensary.  If  there  is  a 
social  worker  in  the  clinic  it  is  best  to  have  all  ar- 
rangements go  through  her." 


CASE  ANALYSIS 


"In  order  to  understand  a  hospital  patient's  disease 
we  should  know: 


a.  Physicallylg^l^f  ^^^  functions 


1.  The 
individual 


b.  Mentally 


2.  His 

environment 


a.  Physically 


b.  Mentally 


Habits 

Habits 

Interests 

Abilities 

Fears,  worries,  etc. 

Food  and  clothes 
Housing 

Work  conditions 
School  conditions 
Income  and  outgo 

Family  and  friends 

Workmates 

Schoolmates 

Recreation 

^Religion" 


The  above  quotation  is  taken  from  a  paper  by  Dr. 
Cabot  published  in  the  ''Modern  Hospital,"  March, 
1916.  If  we  agree  with  Dr.  Cabot  (I  think  few  will 
question  his  statement)  that  the  physician  must  know 
his  patient  both  from  the  physical  and  the  environ- 
mental side,  and  since  the  physician's  time  is  com- 
pletely filled  with  the  study  of  the  physical,  it  is 
evident  that  information  concerning  the  environ- 
mental must  be  supplied  to  him  through  the  medium 
of  social  service. 


22  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 
CASE  WORK 

A.  Patients: 

I.  How  referred: 

a.  Inside  the  hospital,  (admitting  officers,  doctors, 
nurses,  social  workers.) 

b.  Outside  the  hospital  (social  agencies). 

II.  Why  referred  and  methods  of  handling: 

a.  Home  adjustment;  visits  to  home,  to  relatives, 
friends,  employer  and  clergyman. 

b.  Work  adjustment:  investigation  of  character 
and  place  of  employment;  interview  with 
employer. 

c.  School  adjustment:  visit  to  school,  interview 
with  teacher,  withdrawal  from  school,  or  trans- 
fer to  special  class. 

■  (For  special  classes  see  directory,  S.S.D.  office) 

d.  Hospital  care. 

(1)  Pay  Patients: 

(a)  Applying  for  admission  to  JHH  should 
be  referred  directly  to  Admitting  officer. 

(b)  If  no  room  in  JHH,  phone  other  hospital 
for  admission  (see  telephone  directory). 

(2)  Free  Patients: 

(a)  If  there  is  no  room  in  JHH,  and  patient 
has  resided  in  Baltimore  for  one  year, 
phone  Plaza  2000,  Clerk  of  the  Super- 
visors of  City  Charities  office,  329 
Courtland  St.,f  or  bed  in  another  hospital. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  23 

Or  if  patient  has  chronic  disease,  a  recom- 
mendation blank  may  be  filled  by  the 
doctor's  order  and  the  patient  sent  to 
above  office  for  admission  to  Bay  View 
Hospital. 

(b)  Should  the  patient  be  too  ill  to  make 
personal  application,  a  relative  or  friend 
may  take  recommendation  and  secure 
admission  slip  from  the  Clerk  of  Super- 
visors of  City  Charities.  If  ambulance 
case,  special  permission  may  be  asked 
to  send  patient  without  admission  slip. 
Information  can  be  given  by  phone  to 
the  Clerk  who  will  transmit  same  to  the 
hospital  and  secure  the  use  of  the  City 
ambulance.  The  JHH  recommenda- 
tion must  be  mailed  immediately  to  the 
Supervisor's  office.  It  is  possible  to 
secure  use  of  the  JHH  ambulance 
through  the  admitting  officer  if  the  City 
ambulance  is  not  available. 

The  Social  Service  Ford  may  be  requi- 
sitioned in  the  Social  Service  office. 

(c)  If  there  is  no  room  in  the  JHH,  and 
patients  reside  in  Maryland  but  not  in 
Baltimore,  phone  to  the  Secretary,  State 
Board  Aids  and  Charities,  405-6  Union 
Trust  Bldg.  (Plaza  2680),  for  care  in  a 
hospital  providing  beds  for  state  pat- 
tients,  or  communicate  with  the  com- 
missioners of  the  county  from  which 
they  come. 


24  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

(d)  Should  the  patient  Hve  out  of  Maryland 
and  be  too  ill  to  travel,  phone  office  of 
the  Supervisor  of  City  Charities  (see 
paragraph  (a)  ),  stating  details  of  the 
case,  and  ask  advice  or  assistance.  In 
some  instances  it  is  possible  for  the 
Supervisor  to  provide  temporary  care 
at  the  BVH  pending  arrangements  to 
send  the  patient  home. 

(3)  A  U.  S.  sailor  may  be  referred  to  United 
States  Public  Health  Service,  Custom 
House,  Gay  &  Lombard  Streets  (phone. 
Plaza  4220).  A  foreign  sailor  may  be  re- 
ferred to  the  consul  representing  his 
country. 

(4)  Contagious  disease  diagnosed  by  a  member 
of  the  JHH  staff  or  by  a  doctor  sent  by 
the  Health  Department,  is  handled  by  the 
latter  office. 

If  the  patient  has  advanced  pulmonary 
tuberculosis  and  has  been  a  resident  of 
Baltimore  for  one  year,  effort  should  be 
m.ade  to  secure  immediate  admission  to 
the  Municipal  Tuberculosis  Hospital. 
If  this  is  impossible,  the  patient  is  sent 
home  and  the  Tuberculosis  Division  of 
the  Health  Department  is  notified.  By 
this  means  the  patient  is  placed  on  the 
waiting  list  for  the  MTH  or  sanatorium, 
and  is  given  nursing  care  pending  admis- 
sion. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  25 

e.  Institutional  Care. 

(1)  A  man  or  woman,  white  or  black,  without 
home  or  funds  and  not  in  need  of  hospital 
care,  can  be  sent  to  The  Friendly  Inn, 
309-11  S.  Sharp  Street  (phone.  Plaza  278). 

(2)  Un-co-operative  patients  living  in  the 
city,  in  the  primary  or  secondary  stages  of 
syphilis  or  gonorrhoea,  may  be  referred  to 
the  Health  Department  (Plaza  320)  to 
enforce  treatments.  Un-co-operative  pa- 
tients living  in  Maryland  outside  of  Balti- 
more may  be  referred  to  the  State  Board 
of  Health,  16  W.  Saratoga  St.  (Plaza 
4810).  Soldiers  and  sailors  are  sent  to 
the  United  States  Public  Health  Service. 

(3)  Should  it  seem  likely  that  the  patient  will 
need  care  for  an  indefinite  period,  the  Bay 
View  Hospital  commitment  can  be  ar- 
ranged through  the  Clerk  of  the  Super- 
visors of  City  Charities,  provided  the 
patient  has  been  a  resident  of  Baltimore 
for  one  year.  Out-of-city  patients  with- 
out home  or  funds  can  be  sent  to  The 
Friendly  Inn  pending  investigation  of  the 
patient's  statement  as  to  his  social  situa- 
tion. 

(4)  Patients  with  mental  disorder  who  are 
residents  of  Maiyland,  after  being  certi- 
fied by  two  physicians  who  are  residents 
of  Maryland  and  have  practiced  for  5 
years,  should  be  referred  to  the  Secretary 
of  the  Supervisors  of  City  Charities,  Court 


26  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

House  (phone,  Plaza  2000);  blank  certi- 
ficates can  be  secured  from  the  HPPC. 
Arrangement  must  be  made  with  the  Sec- 
retary of  the  Supervisors  of  City  Charities 
by  the  nearest  relative.  Non-residents  v/ith- 
out  resources  may  be  referred  to  the  Sec- 
retary of  the  Supervisors  of  City  Charities 
pending  return  to  their  own  state. 
f.  Medical  attention,  nursing  and  convalescent 
care. 

(1)  If  a  patient  residing  in  the  City  needs 
medical  attention  at  home  and  is  unable 
to  pay  for  same,  notify  the  Instinctive 
Visiting  Nurse  Association,  1123  Madison 
Ave.  (phone,  Vernon  469). 

(2)  Patients  over  three  years  of  age,  residents 
of  the  City,  in  need  of  nursing  care  can  be 
provided  with  it  as  follows: 

(a)  If  the  patient  has  non-contagious  disease 
notify  the  Instructive  Visiting  Nurse 
Association. 

(b)  If  the  patient  has  contagious  disease, 
notify  the  Nurses  Division  of  Health 
Department,  311  Courtland  St.  (phone. 
Plaza  230). 

(c)  If  the  patient  has  pulmonary  tubercu- 
losis, notify  the  Nurses  Division  of  the 
Health  Department,  311  Courtland  St. 
(phone.  Plaza  230) 

(d)  Infectious  venereal  cases  receiving  treat- 
ment at  the  dispensary  are  reported  to 
the  City  Health  Department  if  they  can 
not  be  induced  to  come  regularly  for 
treatment. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  27 

(3)  Patients  three  years  of  age  and  under, 
residents  of  the  City,  in  need  of  nursing 
care  can  be  provided  with  it  as  follows: 

(a)  If  the  patient  has  non-contagious  dis- 
ease, notify  the  Babies  Milk  Fund  As- 
sociation, 130  S.  Calvert  St.  (phone. 
Plaza  3271). 

(b)  See  paragraph  (2)  (b). 

(c)  See  paragraph  (2)  (c). 

(d)  Children  needing  surgical  dressings 
should  be  referred  to  the  Instructive 
Visiting  Nurse  Association  (phone,  Ver- 
non 469). 

(4)  Mothers  of  children  needing  country  care 
during  the  summer  can  be  sent  to  The 
Fresh  Air  Farm,  through  the  Children's 
Fresh  Air  Society,  35  Knickerbocker  Bldg., 
Lexington  and  North  Sts.,  (phone.  Plaza 
1268). 

g.  Surgical   Appliance    dental    plates,    diet    and 
material  relief: 

(1)  Patients  residing  in  Baltimore  who  claim 
inability  to  provide  any  of  the  above,  can 
be  referred  to  the  Family  Welfare  Associa- 
tion's district  office  (see  phone  book  for 
addresses). 

(2)  Hebrew  patients  should  be  referred  to  the 
Hebrew  Benevolent  Society,  411  W.  Fay- 
ette St.  (phone,  Calvert  3280.) 

(3)  Roman  Catholic  patients  should  be  refer- 
red to  the  St.  Vincent  de  Paul  Society, 
222  St.  Paul  Street,  (phone,  Plaza  4216). 


28  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

(4)  Abdominal  binders  recommended  in  the 
JHH  dispensary  will  be  furnished  at  re- 
duced prices  by  Miss  Foard,  maker,  711 
N.  Carey  St.  (phone,  Madison  81).  Miss 
Foard  is  in  the  dispensary  on  Tuesdays 
11  a.  m.-12  m.  to  take  orders  and  measure 
patients. 

(5)  Should  the  patient  live  out  of  the  city, 
effort  should  be  made  with  the  patient's 
permission  to  secure  assistance  from  the 
relatives,  friends,  church,  employer  or 
relief-giving  agency  in  his  place  of  resi- 
dence. 

h.  Free  treatment,  lunch  and  car-tickets. 

(1)  24-hour  pass  can  be  given  without  investi- 
gation, permanent  free  treatment  should 
be  given  only  after  investigation.  See 
form  on  page  67. 

(2)  Lunch  can  be  provided,  when  the  patient 
is  unable  to  pay  for  it  and  must  remain 
for  afternoon  clinic. 

(3)  Car-tickets  can  be  given  for  emergency 
use.  (Money  for  lunches  and  car-tickets 
may  be  obtained  from  the  secretaiy.  Social 
Service  ofhce.)     See  form  on  page  65. 

i.  Steering. 

(1)  To  another  clinic  for  examination. 

(2)  To  admitting  office  at  front. 

(3)  Out-^of-towm  patients  to  a  boarding-house, 
j.  Emergency  or  accident  cases. 

(1)  To  accompany  patient  home. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  29 

(2)  To  call  an  automobile  to  take  the  patient 
home.  The  Stewart  taxi-Service  Co., 
7  W.  Eager  St.,  for  white  and  colored 
patients.  Patients  not  ambulance  cases 
may  be  sent  home  or  called  for  in  the  social 
service  Ford  car  if  necessary;  write  requisi- 
tion in  the  register  in  central  office. 

(3)  To  notify  patient's  relatives,  friends  or 
employer  of  illness  either  in  person  or  by 
telephone. 

k.  Return  visits. 

Efforts  should  be  made  by  letter  or  visit 
to  secure  return  of  patients  to  the  clinic, 
if  further  treatment  is  advised. 

1.  Reports. 

Diagnosis  and  recommendation  as  to  treat- 
ment may  be  given  to  other  medical  or 
social  agencies  or  to  responsible  individuals, 
(i.  e.,  friend,  relative  or  employer.)  See 
page  62. 


30  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

RECORDS 

ATTITUDE  TOWARD  RECORDS. 

"There  is  a  certain  natural  tendency  in  most  of  us 
to  exalt  the  record  as  an  end  in  itself,  a  tendency  to 
feel  that  something  has  actually  been  accomplished 
in  the  disposition  of  a  case  when  a  statement  appears 
in  black  and  white.  We  are  a  little  too  inclined  to 
feel,  perhaps,  that  the  aim  of  asking  questions  of  the 
persons  we  are  interviewing  is  to  get  material  to  fill 
the  blank  spaces  on  a  yellow  card.  A  record,  how- 
ever, is  only  a  tool  to  be  made  keen  and  kept  avail- 
able for  use.  Only  that  should  go  into  a  record  which 
will  help  the  agency  whose  tool  it  is,  in  the  working 
out  of  the  problem  which  this  particular  case  presents 
or  which  will  aid  in  the  interpretation  of  other  cases. 
There  may  possibly  be  material  introduced,  which, 
though  of  no  available  use  at  the  time  there  cord  is 
made,  may  furnish  data  for  a  special  inquiry  of  one 
kind  or  another.  The  record  should  not  be  used  to 
stand  for  the  justification  of  the  worker — for  instance 
that  she  lost  a  great  amount  of  time  in  trying  to 
establish  a  telephone  connection.  The  record  stands 
for  the  establishment  of  definite  human  relationships. 
It  grows  and  takes  new  force  as,  because  of  these  re- 
lationships, things  happen." 

THE  DANGER  OF  BECOMING  MECHANICAL  IN  WORK 

"It  is  always  easy  to  do  a  thing  in  the  same  way  we 
have  done  it  a  hundred  times  before;  it  saves  the 
trouble  of  thinking.     In  social  work,  because  of  its 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  31 

nature,  action  merely  mechanical  is  fatal  to  real  ac- 
complishment. We  must  ask  our  questions,  not 
because  we  believe  that  such  questions  always  are 
asked,  but  because  we  want  to  find  out  certain  things. 
When  we  visit  a  home  we  notice  the  surroundings  of 
the  house,  the  hallways,  the  light,  the  cleanliness,  the 
ventilation,  the  sleeping  arrangements,  the  toilet 
conveniences,  etc.,  not  because  a  complete  report  is 
expected  of  us,  but  because  the  man  or  woman  whose 
problem  we  are  trying  to  understand  and  help  solve 
is  vitally  affected  by  these  things.  They  bear  a 
direct  relation  to  his  past,  his  present  and  his  future. 

"The  method  we  employ  in  a  given  case  should  not 
necessarily  be  the  one  that  happens  to  occur  to  us 
first;  it  should  be  chosen  because  we  have  reason  to 
think  it  will  bring  the  best  results.  It  represents  a 
conscious  taking  of  heed  in  the  matter." 

THE  NEED  OF  ACCURACY  AND  COMPLETENESS  OF 
INFORMATION 

''Inaccurate  information  is  practically  valueless  or 
positively  harmful  as  a  social  history.  So  often  one 
stops  short  just  a  step  too  soon.  Go  on  and  you  get 
a  clear  view  of  the  situation;  stay  where  you  are  and 
there  is  nothing  but  haziness  about  you.  You  must 
follow  up  your  clues.  A  woman  tells  you  that  she 
has  had  a  great  deal  of  sickness.  You  do  not  find  out 
how  long  ago  the  illness  occurred,  how  and  by  whom 
she  was  treated,  what  hospital  care,  if  any,  she  re- 
ceived. You  expect  to  be  able  to  make  a  plan  for  her 
future  treatment  without  any  idea  as  to  how  she  re- 
acted to  treatment  in  the  past.  Or  she  gives  you  the 
name  and  address  of  an  attendant  physician  and  you 
get  it  almost  right,  but  find  later  that  your  informa- 
tion will  not  identify. 


32  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

"Before  you  are  prepared  to  make  any  plan  in  a 
given  case  you  must  have  both  complete  and  accurate 
information.  With  your  deep  realization  of  this 
comes  a  very  real  change  in  attitude  as  investigator- 
You  lose  the  feeling  that  you  are  intruding,  in  your 
interest  in  a  human  situation. 

"Carefully  prepared  histories  should  furnish  valu- 
able data  for  research  work." 

THE  NEED  OF  GETTING  RESULTS 

"In  most  cases,  our  getting  results  is  dependent 
upon  a  great  amount  of  questioning  and  record- 
writing,  on  use  of  the  telephone  and  the  postman,  and 
it  is  fairly  easy  to  confound  effort  made  with  results 
obtained. 

"Whether  the  two  are  even  closely  related  depends 
upon  the  competency  of  the  worker.  Has  she  the 
skill  to  get  a  complete  statement  of  the  situation,  the 
wisdom  to  interpret  it,  and  the  power  to  act  according 
to  a  well-conceived  plan,  then  there  will  probably  be 
little  wasted  energy.  She  will  be  saved  the  only  too 
common  experience  of  filling  her  days  full  of  comings 
and  goings  which,  because  they  do  not  lead  to  an  ac- 
complished goal,  are  meaningless." 

RECORDS  SHOULD  SHOW 

1.  Cause  as  well  as  effect. 

2.  Results: 

a.  What  has  been  accomplished. 

b.  Failures  as  well  as  successes. 

3.  What  other  agencies  are  needed  in  the  com- 

munity. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  33 

4.  How  far  problems  of  disease  are  affected  by 

environment. 

5.  Where  relief  is  necessary  is  it  adequately  given? 

6.  Definite  status  at  time  case  is  closed. 

TYPES  OF  RECORDS 

There  shall  be  six  types  of  case  records:  i.e.  (A) 
page  41,  statistical  records;  (B)  pages  42, 44, 45,  inten- 
sive case  records;  (C)  pages  43  to  45,  special  case 
records;  (D)  Same  as  (A),  short  service  records; 
(E)  page  46,  social  service  records  for  dispensary  his- 
tories; (F)  page  47,  steering  blank  records. 

STATISTICAL  RECORDS 

Statistical  records,  see  sample  (A)  on  page  41,  of 
all  new  cases  after  being  filled  in  by  long  hand  should 
be  put  in  wire  basket  No.  1  in  the  record  room.  The 
secretary  will  number,  make  index  cards  if  intensive 
case  and  duplicate  card  for  permanent  record  if  short 
service  case,  and  return  the  original  card  to  wire 
basket  No.  2. 

A  statistical  card  in  the  index  file  indicates  no 
social  service  record  except  the  yellow  sheet  filed  with 
the  medical  record. 

INTENSIVE   AND   SHORT   SERVICE   CASE   RECORDS 

Samples  ((B)  and  (C)  on  pages  42  to  45)  are 
kept  in  addition  to  the  statistical  record  when  inten- 
sive case  work  is  undertaken.  Should  a  case  be 
started  as  a  short  service  case  and  develop  into  an 
intensive  case,  a  (B)  or  (C)  record  is  made  and  it  is 


34    ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

indexed  and  handled  as  in  the  intensive  cases.  Date 
of  birth,  not  age,  should  be  given.  Present  tense  is 
used  in  history  writing.  Notes  are  entered  chrono- 
logically. 

An  intensive  history  has  one  family  face  sheet  (B 
No.  1,  page  42  or  C  No.  1,  page  43).  It  has  as  many 
individual  face  sheets  (B  and  C  No.  2,  page  44)  as 
there  are  patients  in  the  family  treated  by  social 
service. 

In  speaking  of  a  doctor,  mention  his  name  and 
position  on  the  staff  or  in  the  clinic. 

In  speaking  of  a  patient,  be  sure  to  mention  him 
by  name,  prefixed  "In  re"  in  red  type. 

In  mentioning  other  persons  state  name  and  rela- 
tion to  the  patient. 

In  mentioning  co-operating  agencies  state  the  name 
and  official  position  of  the  worker  interested  in  the 
case. 

Always  use  official  title  of  agencies  and  institutions. 

Social  Service  Records  For  Dispensary 
History 
(yellow  sheet) 
A  social  service  history  (E),  page  46,  filed  with  dis- 
pensary records  is  made  with  each  case  treated  by 
social  service.     (N.  B.  A  note  may  be  made  on  the 
medical  history  instead  of  making  up  the  yellow 
sheet  in  cases  referred  for  return  visit  or  immediate 
hospital  care.) 

OLD  HISTORIES 

Make  up  a  No.  2  sheet  for  a  re-instated  patient,  if 
such  a  sheet  is  lacking.  Confirm  household  as  it 
appears;   add   new   names   if  any;   confirm   the 

ADDRESS. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  35 

When  histories  are  re-instated,  a  memorandum  of 
change  of  address,  deaths,  births,  etc.,  should  be 
attached  to  the  history,  so  the  necessary  note,  cor- 
rections, or  additions  may  be  made  on  the  file  cards. 

In  the  case  of  the  death  of  a  patient,  write  in  red 
ink  "Died"  (and  give  date)  after  the  name  on  No.  1 
and  No.  2;  of  the  death  of  a  member  of  the  family, 
write  in  red  ink  ''Dead"  after  name. 

LETTERS 

Copies  of  letters,  either  in  whole  or  in  abstract,  are 
embodied  in  histories,  with  note  ''See  letter  No. — " 
Letters  are  then  marked  with  S.  S.  number  and 
number  of  letter  and  put  into  file  drawer. 

MAKING    CORRECTIONS    IN    TYPEWRITTEN    WORK 

A  small  cross  mark  (x)  opposite  the  line  will  call 
attention  to  any  error  in  typing;  any  change  in 
phraseology  is  indicated  by  writing  in  margin. 

Do  NOT  UNDERSCORE  WHEN  A  CHANGE  IS  DESIRED. 
FOLDERS 

Surname,  father's  and  mother's  Christian  names 
are  typed  in  the  extreme  left-hand  corner,  social  ser- 
vice number  in  right-hand  corner. 

care  of  records 
Folders  are  never  taken  from  the  drawer 

EXCEPT: 

1.  When  histories  are  closed  at  the  end  of  the 

month. 

2.  When  cases  are  re-instated. 

3.  When  closed  histories  are  pasted  in  the  folder. 


36  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

In  the  first  instance  a  note  "closed"  is  attached  to 
the  folder;  in  the  second,  a  note  *Ve-instated/'  (ab- 
breviated R.-I.)  with  the  worker's  initials  and  the 
department,  is  attached  to  the  folder,  and  it  is  put  in 
the  file  drawer.  Closed  histories  are  pasted  in  the 
folder  by  the  Secretary. 

All  histories  are  filed  in  the  central  office  except 
those  active  in  HPPC,  or  HLH.  Active  his- 
tories are  filed  alphabetically;  no  histories  are  to  be 
kept  out  of  the  files  over  night. 

Whenever  a  history  is  taken  from  its  folder  a  note 
(see  form  below)  must  be  left  in  its  place. 

No  1 

Size  5"  by  3'' 


HISTORY  NO NAME  . 


HELD  IN  DEPARTMENT  . 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  37 

When  a  pasted  history  is  taken  from  the  drawer  a 
temporary  folder  is  put  in  its  place,  containing  note 
stating  department  held  in,  date,  and  by  whom  taken. 
A  blank  for  the  purpose  will  be  found  on  top  of  the 
filing  cases.  (See  page  36). 

When  a  history  is  reinstated  inHPP  C  orHLH 
the  original  folder  is  put  into  the  file  drawer  with 
proper  note  (as  above)  and  a  temporary  folder  is 
made  in  the  branch  office. 

OUTLINE  FOR  WRITING  HISTORIES 

Date: 
Worker's  name,  department,  stenographer's  initials. 

IN  RE:  Patient's  Name. 

I.  Referred  by:  Co-operating  agency,  doctor,  student, 

personal  application,  etc. 

II.  Why   referred:  Concise  statement  of  reason  for 

referring. 

III.  Medical  Data: 

1.  Name  and  rank  of  doctor  who  gives  the  follow- 
ing information :  stated  in  medical  terms  and  in 
descriptive  terms  intelligible  to  lay  persons,  and, 
if  more  than  one  disease  is  present,  which  is  the 
more  important  for  treatment. 

Summarize  special  findings,   e.g.,   tests  and  re- 
actions. 

2.  DIAGNOSIS. 


38  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

3.  PROGNOSIS. 

When  will  pt.  probably  be  restored  to  normal 
condition.  Disability -permanent  handicap-work, 
when  will  pt.  be  able-kind-amount-social  condi- 
tions that  may  affect  prognosis. 

4.  TREATMENT. 

Where  to  be  obtained — 0  P  D-other  hospitals- 
medicine-dressings-prescription  and  instructions- 
date  to  return. 

5.  PREVIOUS  MEDICAL  FACTS. 
When  significant. 

Treatment — where  obtained. 

IV.  Personal  Appearance. 

When  significant. 

V.  Home  Conditions.     From  whom  and  by  whom 

obtained;  from  home  visit  whenever  possible. 
Number  of  rooms,  flights,  location,  sun  and  air, 
yard,  piazza,  plumbing,  modern  improvements, 
approach  to  house,  frame  or  brick,  street.  Order. 
Cleanliness. 

VI.  Family  Background  or  History. 

Social  status.  Length  of  time  in  United  States 
and  at  different  addresses.  Reasons  for  coming 
to  Baltimore.  Date  and  place  of  marriage. 
Significant  events  in  family  life.  Religious  con- 
nections. 

VII.  Personal  History: 

a.  Education:  Ability  to  read  and  write. 
Grade  reached  in  school. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  39 

Trade  or  evening  school. 

If  at  school,  grade  and  teacher. 

Distance  from  school,  walk  or  ride. 

b.  Industry:  Name  of  industry,  foreman  and  work 
number. 

Hours  of  work,  sitting  or  standing. 

Female,  distance  from  home,  walk  or  ride. 

Time  in  present  position,  frequent  change  and 

reasons. 

Earnings. 

c.  Social    connections   and    recreation.     Kind    of 
recreation — out-of-doors.     Companions. 

d.  Habits.     Disposition,    attitude   towards  home 
and  relationships  within  family. 

e.  Personal  hygiene.     Diet. 

VIII.  Analysis  of  members  of  family  and  household. 

a.  Health. 

b.  Work. 

c.  Attitude  toward  patient  and  treatment. 

IX.  Financial  Data. 

Total  earnings  of  all  wage  earners  (gross  income). 
Amount  given  to  family  budget  (net  income.) 
Itemized  list  of  expenditures;  rent,  union,  dues. 

X.  Relatives. 

Significant  facts — relationship,  number  of  child- 
ren, health,  finances. 
XL  Patient's  Statement  of  Difficulty  and  Plan. 

XII.  Personal  Impression.     When  significant. 


40  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

XIII.  Reports   from   relatives,    doctors,    ministers, 
other  agencies. 

(Paragraphed  separately). 

XIV.  Tentative  social  plan. 

(Including    statement    of    emergency    action.) 
Next  steps — medically,  socially. 

XV.  Action  taken. 
Chronological. 

In  re:  patient's  name,  whenever  note  refers  to 
different  patient. 

XVI.  Summary. 

(Very  brief,  when  case  is  closed). 

1.  Action  taken. 

2.  Present  status  of  case. 

Outline  for  Yellow  Sheet 
Outline  for  Yellow  Sheet: 

Referred  by: 

Diagnosis: 

Why  Referred: 

Social  Situation: 

Action  Taken:  status  at  time  of  closing. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  41 

FORMS: 
A 

Size  5''  by  3" 


THE  JOHNS  HOPKINS  HOSPITAL  SOCIAL  SERVICE  DEPARTMENT 

NAME 

WORKER 

ADD. 

OCCU. 

D.  OF  B. 

W.  B.                                               M.  F.                                       S.M.W.D. 

DEPT. 

DISP.  NO.                          S.  S.  NO. 

DIAG. 

REF.  BY 

OP. 

CLOS.                                               TRANS.                                          DIED 

NEW 

REIN. 

INTBN.                     SHORT  SER.                     NOT   REG 

REL. 

CO-OP.  AG. 

Reverse  Side  of  A 


42  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

Bl 

Size  6i^"  by  9 v<" 


THE    JOHNS   HOPKINS   HOSPITAL 

SOCIAL   SERVICE    DEPARTMENT 

DATE  S.  S.  NO. 

SURNAME  RACE  C.  E.  OF  I. 

CROSS  REF. 

DATE  ADDRESS  HOUSE     ROOMS     FLOOR     RENT  PER  WK. 


DATE  PREVIOUS   ADDRESS  HOUSE     ROOMS     FLOOR     RENT  PER  WK. 


NO.      HOUSEHOLD       RELATION      D.   OF   B.      BIRTHPLACE      OCCUPATION      DISP.   NO. 
1 

2 
3 

4 
5 
6 

7 


RELATIVES  ADDRESS  RELATIONSHIP 


AGENCIES   AND   INDIVIDUALS  INTERESTED   IN 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  43 

CI 

Size  6^/^"  by  9}4'' 


THE   JOHNS 

HOPKINS   HOSPITAL 

SOCIAL   SERVICE   DEPARTMENT 

DATE 

S.  S 

NO. 

SURNAME 

RACE 

C.  E.  OF 

. 

CROSS  REF 

DATE 

ADDRESS 

HOUSE      ROOMS      FLOOR 

RENT  PER  WK. 

DATE 

PREVIOUS  ADDRESS 

HOUSE      ROOMS      FLOOR 

RENT    PER 

WK. 

NO.       HOUSEHOLD                                    D.  OF  B.     RESULT  OF  EXAM.     DISP.  NO 

OCCUPATION 

DATE  INT. 

RELATIVES 

ADDRESS 

RELATIONSHIP 

DATE  INT. 

AGENCIES  AND  INDIVIDUALS 

INTERESTED 

IN 

44  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

B&C2 


Size  6y2"  by  9>^" 


THE   JOHNS   HOPKINS   HOSPITAL 

SOCIAL   SERVICE    DEPARTMENT 


s.  s.  NO. 


NAMB 

ADDRESS 

BIRTHPLACE 

FAITH 

DATE  DIAGNOSIS 


OTHER  DEPT  S.  TREATED  IN 


PREVIOUSLY  TREATED  AT 


ENTERED  INSTITUTION 


DATE 

AGE  M.  OR  F.  S.M.W.D. 

HOW  LONG  IN  U.  S.  HOW  LONG  IN  BALTO.  CITIZEN 


DIAGNOSIS 


DATE  OCCUPATION   OB  SCHOOL  PROCESS  OR    GRADE  WKLY.   WAGE 


DATE  EMPLOYEE  OR  PRINCIPAL      FOREMAN  OR  TEACHER  ADDRESS 


BENEFIT  SOCIETIES  TRADE      UNION  INSURANCE       WKLY.  PREMIUM 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  45 


B&C3 

Size  6X''  by  9^'' 


JOHNS   HOPKINS   DISPENSARY 

SOCIAL  SERVICE   DEPARTMENT 


NARRATIVE 


46  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

E 

Size  6j<^"  by  9^''  (Stiff  buff  card) 


THE   JOHNS    HOPKINS    HOSPITAL   DISPENSARY,    NO. 

SEX  DATE 

SSS  SEX  i 

BIRTHPLACE  OCCUPATION 

SOCIAL  SERVICE    DEPARTMENT   No. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  47 

F 

Size  BVs''  by  9)4'' 


JOHNS   HOPKINS   DISPENSARY 

SOCIAL   SERVICE    DEPARTMENT 

Referred  by Date .  .  .  . 

Fees  to  be  omitted.     Yes.     No. 

Name Date  of  birth . 

Address 

Church Birthplace .  . 

How  long  in  the  United  States ;  in  Baltimore? . 

If  a  child,  names  of  parents 

Significant  facts  in  family  and  personal  history,  physical  and  social 


Significant  facts  about  environment . 


EMPLOYMENT 
Nature Hours . 


Place Wages . 

School Grade .  .  . 


PREVIOUS   MEDICAL  ATTENTION 
Places: Date . 


Reason  for  referring. 


(The  blanks  below  are  to  be  filled  in  by  physician  for  information  of  Social  Service 
Department) 

Diagnosis: 

Recommendations: 


48  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 


Size  ^Vs"  by  Ws"  (Yellow  Sheet) 


c 

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m 

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a 

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L 

ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  49 


Sheet  used  by  volunteers  in  writing  up  case  visits. 

USE  OF  MEDICAL  RECORDS 

Histories  of  discharged  house  patients  may  be 
secured  from  the  clerk  in  the  history  room  (third  floor 
of  surgical  building)  upon  presentation  of  blank  (see 
below),  after  being  signed  by  the  chief  of  S.  S.  or  a 
member  of  the  staff  authorized  by  her. 


DATE. 
PLEASE  ALLOW 


Miaa 

TO  SEE  THE  HISTORY  OP 


SOCUL  SERVICE   DEPARTMENT 


Dispensary  records  may  be  secured  from  the  clerk 
at  the  desk  by  signing  the  book  kept  on  the  desk  for 
that  purpose. 


50  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

When  a  number  of  dispensary  histories  are  needed 
in  making  reports,  etc.,  give  the  dispensary  clerk  a 
Hst  containing  the  dispensary  numbers  arranged 
numerically,  between  the  hours  of  11  A.M. — 12  M.or 
3-4  P.  M.     See  sample  below. 

Size  Ayi"  by  11"  (or  shorter) 


SOCIAL  SERVICE  DEPARTMENT 

REQUIRED  FOR  SOCIAL  SERVICE  INVESTIGATION 
HISTORY  NtJMBEai:  DATE      RETURNED: 


DATE DEPARTMENT 

Histories  requisitioned  before  9.30  can  be  gotten  by  12  o'clock.     Those  re- 
quisitioned before  2  P.  M.  by  4  P.  M. 

More  than  15  histories  cannot  be  taken  from  the  files  at  one  time. 


or(;a>:ization  and  method  in  social  service  51 

registration  of  cases 

Cases  are  registered  consecutively  by  assistant 
secretary  without  regard  to  the  cHnic  from  which 
they  are  referred;  the  social  service  number  is  given 
to  the  family. 

New  statistical  records  are  placed  by  the  worker, 
on  the  date  the  case  is  refeiTed,in  the  wire  basket  kept 
in  the  central  office.  Before  registering  a  case  the 
assistant  secretary  will  look  through  the  card  file  to 
ascertain  if  the  patient  or  his  family  has  been  known 
to  social  service;  if  so,  the  original  number  is  given  to 
the  case  historj^  A  slip  of  paper  is  attached  to  the 
history,  naming  the  clinic  in  which  the  family  is 
known,  and  the  history  is  given  to  the  worker. 

Statistical  histories  will  be  kept  by  the  worker  until 
the  end  of  the  year  when  if  closed  they  will  be  de- 
stroyed. One  patient  may  have  a  statistical  record 
in  several  clinics. 

The  workers  are  expected  to  look  through  the 
active  history  drawer  at  the  end  of  each  month  and 
see  that  all  quiescent  histories  are  closed. 

CARDS 

White  catalogue  cards  are  used  when  there  is  any 
histoiy  of  the  case  in  the  social  service  files  (see  No. 
1,  page  37),  short  service  cards  when  there  is  only  a 
statistical  history  (see  A,  page  41).  ''Steering  blank" 
is  written  in  red,  top  line  of  v/hite  card  lo  indicate 
steering  case. 

If  two  or  more  clinics  are  carrying  statistical  records 
on'y  of  the  same  patient,  subsequent  clinics  with  the 
dates  should  be  entered  on  the  same  card,  under 
'^Remarks." 


52  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

The  family  card  No.  3  (page  54)  is  practically  self- 
explanatory,  except  that  under  ''Relatives"  may  be 
,  listed  without  addresses,  only  those  relatives  having 
[the  same  surname,  including  married  sons  of  the 
family  with  which  yoU  are  dealing.  Give  year  of 
birth,  not  age. 

If  the  history  gives  the  names  of  both  parents,  and 
one  is  dead,  after  the  Christian  name  write  ''dead" 
(in  red;  if  one  parent  is  dead,  and  the  Christian  name 
,is  not  given,  write  "dead"  after  M  or  W  in  black. 
(     If  a  woman  has  been  mamed  more  than  once,  and 
has  had  children  by  the  f  oiTner  marriage  or  marriages, 
their  names,  giving  surnames,  are  listed  and  under- 
neath is  written  in  black,  "Ws"  by marriage; 

lif  there  are  children  by  the  present  union,  their 
-  Christian  names  follow.  In  a  similar  way  are  indi- 
j  jDated  children  by  the  former  marriages  of  the  man. 

A  relative  (buff)  card  (see  No.  4,  page  54)  is  made 
.)Up  for  the  children  by  the  former  marriages  of  the 
1  wife,  names  arranged  in  alphabetical  order,  the  same 
form  being  used  as  with  relatives  cards. 

Patient's  card  (see  A,  page  41)  bears  name,  ad- 
dress, "See"  (surname,  parents'  Christian  names)  in 
red,  and  diagnosis,  on  left-hand  side,  and  S.S.  num- 
ber, date  (of  coming  to  S.S.D.),  department  in  which 
treated,  and  dispensary,  house  or  service  number  on 
the  right-hand  side. 

Patient's  card  bears  the  *  in  the  extreme  left-hand 

corner  to  indicate  that  there  is  no  family  card. 

^ '"'When  deaths  occuf  write  after  the  names  on  the 

'family  card  "dead"  in  red.     If  the  deceased  were 

'  patients,  make  a  similar  notation  on  the  index  cards. 

Add  births  to  family  cards. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  53- 


Relatives'  cards  (buff)  are  made  up  for  married 
daughters  and  for  all  other  relatives  of  different  sur- 
names, and  below  in  red  beginning  at  the  extreme 
left,  "See  (surname,  patient's  Christian  name)", 
and  to  the  extreme  right,  S.S.  number  of  the  family 
with  which  you  are  dealing. 

Occasionally  it  will  be  found  necessary  to  make  up 
cards  for  persons  other  than  relative.  For  instance 
in  the  case  of  an  unmarried  mother,  a  card  should  be 
made  for  the  man  in  the  case  if  his  name  is  known. 
(The  buff  card  is  used.)  If  there  is  a  B  No.  1  or  C 
No.  1  (pages  42  and  43)  sheet,  the  girl's  name  and  the 
name  of  the  child  appear  on  the  family  card.  If  the 
child  is  known  by  the  same  name  as  the  man,  both 
the  child's  name  and  the  man's  name  should  appear 
in  alphabetical  order  on  a  relative  card. 

Black  capital  ''C",  center  top  line,  indicates  a 
colored  patient  and  appears  on  patient's  and  rela- 
tives' cards. 

When  the  family  goes  by  two  or  more  names,  cross- 
reference  cards  are  made  out  for  the  other  names. 

Attention  is  called  to  the  fact  that  B  No.  1  and 
C  No.  1  sheet  show  "Household,"  while  the  cards 
are  called  "Family  Cards." 


54  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 


No.    3 

Size  5"  X  3" 


SURNAME 

U 

w 

DATE 
RACE 

S.  S.  NO. 

ADDRESS 

CHILDREN 
NAME 

D.  OF  BIRTH 

CHILDREN 
NAME                             D.  OF  BIRTH 

RELATIVES 

No.  4 
Size  5"  X  3" 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  55 

STATISTICS 

MONTHLY     SHEETS 

Each  worker  shall  keep  a  monthly  statistical  sheet 
;see  J,  pages  57  to  59).  The  first  time  a  patient  is 
referred  to  the  social  worker  he  is  **new,"  whether  or 
not  the  family  is  known  to  the  department.  His  social 
service  number  is  that  given  to  the  family.  He  is' ''new/' 
if  he  has  been  knovm  to  another  clinic.  He  is  "old," 
if  carried  forward  in  that  clinic  from  the  preceding 
month  for  attention.  He  is  "reinstated,"  if  he  has 
been  previously  referred  from  that  clin'c,  has  been 
''closed/'  and  is  again  made  "active." 

TRANSFERRED  CASES 

Cases  may  be  transferred  from  one  JHH  clinic  to 
another  or  to  an  outside  agency. 

CLOSED 

A  case  that  is  quiescent  in  the  social  service  de- 
partment. 

At  the  end  of  each  month,  data  called  for  shall  be 
entered  on  the  monthly  sheets.  (See  J-2  and  J-3, 
pages  58  and  59)  from  the  statistical  records  carried 
during  the  month. 

On  or  before  the  fifth  day  of  each  month  all  clinic 
monthly  sheets  (see  J-1,  page  57)  are  returned  to  the 
supervisor  who  will  have  the  totals  entered  on  the 
department  sheet  (see  H,  page  49),  which  includes 
statistics  for  the  entire  department.  Within  one 
week,  all  department  sheets  shall  be  returned  to  the 
worker  in  charge  of  the  department  (wire  basket  No. 
2  for  registered  histories). 


56  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 


J-1 


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CASES  CLOSED 

Closed 

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Visits  to  patients 

SPECIAL  GROUPS 

ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  57 


J-2 

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DATE: 

DEPARTMENT 

PROBLEMS 

ADJUSTMENTS 

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FAMILY 

COMMUNITY 

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58  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 


J-3 

Size  W^"  X  103^'' 


DEPARTMENT: 


SUMMARY 


NEW  CASES 


CLOSED  CASES 


INTENSIVE 
SHORT  SERVICE , 
TOTAL 


INTENSIVE 
SHORT  SERVICE. 
TOTAL 


ADULT  CHILD 


MALE  FEMALK 


WHITE  BLACK 


REFERRED  FROM 


DISPENSARY  ADMITTING  ROOM  OTH^iR   SOURCES 


PERSONAL  PROBLEMS 
FAMILY  PROBLEMS 
COMMUNITY  PROBLEMS 


BAD  NOT  VISITED 


.UjUsJTMlSNTt 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  59 

H Size  W  X  8}^"  (blue  sheet) 


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60  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

CONFIDENTIAL  EXCHANGE  OF 
INFORMATION 

*'The  confidential  exchange  is  a  fundamental  prin- 
ciple in  efficient  co-operation  between  social  agen- 
cies. 

PRINCIPLES  OF  C.  E.   OF  I. 

"Prevents  d\iplication  and  strengthens  co-opera- 
tion between  agencies.  Protects  the  patient  from 
unnecessary  investigation  and  mental  confusion 
arising  from  conflicting  advice.  A  means  of  settling 
identification.    Supplies  valuable  information." 

REGISTRATION  CF  CASES 

All  new  and  reinstated  cases  are  registered  with  the 
C.  E.  of  I.  by  the  secretary  in  the  central  office. 
Forms  are  supplied  upon  request  by  the  Confidential 
Exchange  of  Information,  Calvert  and  Pratt  St. 
(phone  Plaza  3271).    See  page  59. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  61 


Size  4"  X  6" 


SURNAME 

NO. 

1  MAN'S   FIRST   NAME 

woman's  maiden  name 

2  woman's  FIRST  NAME 

1                                    BORN 

MAN 

RACE 

NATIONALITY                OCCUPATION 

2                                    BOBN 

WOMAN 

RACE 

NATIONALITY                OCCUPATION 

ALIAS 

m 

PREVIOUS  MARRIAGE 
M 

w 

W 

address 

DATE 

CHILDREN 

BORN                                       ADDRESS  IF  DIFFERENT 

3 

4 

5 

6 

7 

8 

9 

10 

RELATIVES 

ADDRESS                                                           RELATION 

62  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

Information  returned  by  the  C.  E.  of  I.  is  attached 
by  the  secretary  to  the  history,  if  the  case  is  active  in 
the  S.S.D.  and  placed  on  the  worker's  desk.  If  the 
case  is  closed  the  information  is  entered  on  the  face 
sheet  by  the  secretary. 

GIVING    INFORMATION    TO    OUTSIDE    AGENCIES    AND 
INDIVIDUALS 

Extreme  caution  should  be  exercised  in  giving  in- 
formation about  patients. 

No  diagnoses  are  given  out  by  the  social  service 
department  except  in  connection  with  their  own  pa- 
tients, and  to  agencies  or  individuals  known  to  the 
worker  and  who  need  our  assistance  in  making  a  plan 
for  the  patient's  welfare.  Before  giving  information 
to  be  used  in  Court  or  for  other  legal  purposes  con- 
cerning a  house  patient,  after  being  approved  by  the 
Chief  of  S.  S.,  consult  the  admitting  officer,  or  the 
director  of  the  dispensary  if  a  dispensary  case. 

Reports  of  patients  shall  be  given  dut  only  by  the 
workers  actively  interested  in  them.  If  several 
members  Of  the  social  service  department  in  different 
clinics  are  interested  in  various  members  of  a  family, 
and  a  co-operating  agency  asks  a  report,  each  social 
worker  shall  give  her  own  report. 

If  patient  is  not  known  to  S.  S.,  information  in 
reference  to  house  cases  must  be  secured  through  the 
admitting  officer,  dispensary  cases  through  the 
director  of  the  dispensary. 

STEERING  BLANKS 

Blank  forms  ((F)  page  47)  are  furnished  on  request  to 
outside  agencies.  They  are  required  to  send  them  to 
the  social  service  office  by  patients  for  whom  they 
are  asking  information  and  advice. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  63 

Pertinent  information  from  the  agency  should  be 
given  to  the  doctor  before  he  sees  the  patient. 

The  patient  is  directed  to  return  to  the  social  ser- 
vice department  after  examination.  The  doctor  is 
seen  by  the  social  worker  after  the  examination. 
The  agency  responsible  should  have  the  report  the 
day  the  doctor's  recommendation  is  made. 

By  using  the  blank  form  the  agency  is  certain  of 
receiving  a  report,  the  social  service  department  has 
the  necessary  information  to  enable  the  doctor  to 
make  a  recommendation,  the  patient  is  spared  un- 
necessary questioning  and  a  uniform  spelling  of 
foreign  names  is  assured. 

The  information  is  sent  to  the  outside  agency  by 
letter.  If  not  previously  known  to  the  social  ser- 
vice department  the  steering  blank  is  the  only  record 
of  the  case  necessary  and  is  treated  as  other  histories. 

BILLS,    ORDERS  AND  MONEY 

LEDGER  CARDS 

Ledger  cards,  see  below,  are  filed  for  all  money  re- 
ceived or  advanced,  or  bills  contracted,  containing  in 
addition  to  the  printed  form  the  name  of  the  firm 
from  whom  the  purchase  is  made.  If  installment 
payments,  state  amount,  and  if  made  monthly, 
weekly,  etc.;  if  the  patient  cannot  pay  for  an  ap- 
pliance, state  whether  the  Social  Service  Department 
or  what  outside  agency  is  responsible.  Entry  is 
made  by  the  worker  on  the  ledger  cards  of  first  pay- 
ment on  the  day  the  debt  is  contracted,  or  if  subse- 
quent payments  are  made  to  her  on  small  manilla 
envelopes,  and  handed  to  the  secretary.     Payments 


64  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 


for  appliances  ordered  from  The  Johns  Hopkins 
Hospital  Brace  Shop  are  made  directly  to  the  nurse 
in  charge  of  the  Orthopedic  Clinic,  except  when  an 
outside  agency  has  assumed  responsibility  for  the 
appliance,  then  payment  is  made  through  the  Social 
Service  Department  and,  after  being  entered  on  the 
ledger  card,  the  money  is  turned  over  by  the  secre- 
tary to  the  nurse. 

Size  5"  X  3" 


1      3     5 

NAME 


11       13       15       17       19      21       23       25       27 


29       31 
NO 


ADDRESS 

WORKER 

DATE 

AMOUNT 

REMARKS 

PAID 

DATE 

AMOUNT 

JOHNS   HOPKINS   HOSPITAL 


ORDERS 

For  appliances  ordered  from  the  Charles  Willms 
Surgical  Instrument  Company  use  firm's  order  book; 
for  other  orders  use  outside  requisition  blank  (see 
page  70). 

All  orders  should  be  signed  by  the  chief  of  social 
service.  Nothing  is  to  be  charged  to  the  social  ser- 
vice department  without  a  written  order,  a  copy  of 
which  is  to  be  on  file. 

Checks  should  be  made  payable  to  The  Johns 
Hopkins  Hospital  Social  Service  Department,  and  the 
checks  should  state  for  whom  and  what  remittance 
is  made. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE   65 

Receipts  should  be  given  in  the  name  of  the 
"Chief  of  Social  Service"  per  worker's  initials. 

Orders  on  the  cash  drawer  should  be  approved  by 
the  chief  of  social  service  before  being  presented  for 
payment.  Form,  see  below,  may  be  secured  from 
the  secretary. 

Size  5"  X  3" 


APPROVED. 


Carfare  for  patients  is  paid  by  the  Social  Service 
Department.  Tickets  may  be  secured  from  the 
secretary.  Lunches  for  patients  are  paid  for  by  the 
Social  Service  Department. 

Carfares  for  workers,  and  incidental  expenses  are 
paid  by  The  Johns  Hopkins  Hospital.  A  statement 
is  presented  monthly  on  *Tay-Day"  at  ''the  bank," 
after  being  approved  by  the  Chief  of  Social  Service. 

A  cash  statement,  and  all  bills  contracted  by  the 
Social  Service  Department,  after  being  approved  by 
the  Chief  of  Social  Service,  are  sent  to  the  Controller 
of  The  Johns  Hopkins  Trust  Estate,  1210  Fidelity 
Building,  on  the  twelfth  day  of  the  month. 

Bills  due  the  Social  Service  Department  are  sent 
out  by  the  secretary  on  the  first  day  of  the  month. 


66  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 
INSTALMENTS 

"The  first  point  to  be  considered  when  a  patient 
asks  to  be  allowed  to  pay  for  apparatus  of  any  kind 
on  installments,  is  whether  the  patient  is  able  to  pay 
or  whether  a  charitable  agency  should  be  asked  to 
bear  the  responsibility.  Having  determined  this 
question  and  decided  to  make  it  an  installment  case, 
the  second  point  is  whether  the  patient  should  pay 
full  price  or  be  given  the  benefit  of  a  reduction. 
This  must  be  determined  by  the  social  worker  and 
based  upon  the  patient's  circumstances."  Ortho- 
pedic appliances  and  glasses  may  be  given  free  or  at 
cost  by  the  social  service  department. 

METHOD  OF  PAYMENTS 

Patients  must  fill  out  the  following  blank,  promis- 
ing to  pay  a  definite  amount,  stating  terms,  i.e., 
whether  weekly,  monthly,  etc. 

Size  5"  X  SVs" 


THE  JOHNS  HOPKINS   HOSPITAL 


I  PROMISE  TO  PAY  TO  THE  SOCAL  SERVICE  DEPARTMENT 

ON  OR  before: 

ON  THE  FOLLOWING  TERMS: 


.19. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  67 
METHOD  OF  CLOSING  CASES 

If  it  becomes  evident  that  a  patient  who  is  paying 
for  apparatus  on  installments  cannot  keep  up  the 
payments,  he  should  be  transferred  to  the  free  list 
and  the  worker  on  the  case  should  notify  the  book- 
keeper. 

REQUESTS  FOR  FREE  TREATMENT 

Twenty-four  hour  passes  may  be  given  without  in- 
vestigation. For  longer  periods  requests  for  free 
treatment  must  be  made  on  form  below  after  case 
has  been  investigated,  and  are  not  to  exceed  30  days, 
but  may  be  renewed  at  expiration  if  necessary. 

Size  4:3yi"  X  3K'' 


THE   JOHNS   HOPKINS   HOSPITAL 

DATE 

BEARER DISP.  NO 

IS  RECOMMENDED  FOR  ADMISSION  AT  THE  REDUCED  RATE  OF 

PER  VISIT  FOR FROM  DATE. 

(      TO  APPLY      ) 
THIS  RATE       (NOT  TO  APPLY)  TO  MEDICINES. 

approved:  SOCIAL  WORKER 

ASSISTANT  DIRECTOR 


68  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 
MISCELLANEOUS  FORMS 

Form  used  in  referring  patients  to  Social  Service. 

Size  4^"  X  23^" 


THE  JOHNS  HOPKINS   HOSPITAL    DISPENSARY 


REFERRED  TO  SOCIAL  SERVICE  DEPARTMENT 


PATIENT  S  NAME. 


REASON  REFERRED . 


Discharge  Notice — filled  in  by  interne  in  charge  of 
case. 

Size  6"  X  4" 


THE  JOHNS   HOPKINS   HOSPITAL 

SEND  TO  S.  S.  D.  AT  LEAST  24  HOURS  BEFORE  DISCHARGE 


NAME ADM. .  .  . 

ADDRESS DISCH.  .  . 

AGE M.  F.        W.  B.,      S.M.W.D WARD.  . 

DIAGNOSIS RESUI.T . 


TO  RETURN  1.   NOT  NECESSARY 

DATE  2.  TO  WARD;  OBSERVATION 

DATE  3.  TO  DISPENSARY — OBSERVATION — DRESSING 


RECOMMENDATION : 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  69 

Form  given  by  interne  to  patient  upon  discharge. 
Size  5"  X  3" 


NAME 

PLEASE  COME  TO  THE  JOHNS  HOPKINS  HOSPITAL  DISPENSARY,  MONUMENT  STREET 

AND  RUTLAND  AVE., MORNING  AT  9  O'CLOCK, 

AFTERNOON  AT  2  O'CLOCK  FOR  TREATMENT  IN  THE 

DEPARTMENT. 


BRING   THIS   CARD   WITH  YOU. 


SUPPLIES 

GENERAL  OFFICE 

Supplies  may  be  ordered  any  Thursday  before 
twelve  noon.  The  main  supply  should  be  ordered 
the  first  Thursday  of  each  month.  Requisition  (see 
form  No.  2,  page  71)  is  made  in  duplicate;  after  being 
signed  by  department  chief,  one  is  taken  to  the  office 
of  the  assistant  director. 

Stationery  supplies  are  delivered  at  the  social  ser- 
vice office  on  Saturday,  A  M.  with  the  exception  of 
stamps  for  which  the  secretary  has  to  go  to  the  bank 
on  Saturday  A.  M.  A  duplicate  requisition  is  filed 
in  the  social  service  office  after  checking  up  the 
supplies. 

Separate  requisitions  are  made  for: 

Henry  Phipps  Psychiatric  Clinic 

Phipps  Tuberculosis  Clinic 

Orthopedic  Clinic 

Harriet  Lane  Home 

Johns  Hopkins  Colored  Orphan  Asylum. 


70  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 


DEPARTMENTS 

Each  worker  makes  out  a  requisition  for  supplies 
Wednesday  of  each  week,  before  5  P.  M.  The  sup- 
phes  are  put  on  the  worker's  desk  by  the  assistant 
secretary.  All  requisitions  are  approved  by  the 
department  chief, 

REPAIRS 

Repairs  are  requisitioned  in  the  same  manner  as 
supplies. 

OUTSIDE  REQUISITIONS 

For  ordering  office  furniture  use  requisition  form 
No.  1,  (see  below).  Three  copies  are  made,  after 
being  approved  by  the  department  chief;  two  copies 
are  taken  to  the  office  of  the  assistant  director.  One 
copy  is  kept  on  file  in  the  S.S.  office. 

No.  1 
Size  8^''  X  eVs'' 


THE  JOHNS   HOPKINS   HOSPITAL 

DEIPASTMENT DATE 


PLEASE  FURNISH  THE  FOLLOWING  SUPPLIES: 


DESCRIPTION 


SUPERINTENDENT. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  71 

No.  2 

Size  4K''  X  ly^" 


THE  JOHNS  HOPKINS  HOSPITAL 

REQUISITION   FOR   SUPPLIES  AND    REPAIRS 


TO  THE  superintendent: 

REQUIRED      FOR DEPARTMENT, 


SiGNATimE 

19. 


72  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

OFFICE   RULES 

Members  of  the  staff  are  expected  to  notify  the 
supervisor  of  any  change  of  address  or  telephone 
number. 

When  anyone  is  absent  on  account  of  illness  or 
other  reason  the  supervisor  should  be  notified,  also 
when  unduly  delayed  in  reaching  the  hospital. 

When  there  is  an  inquiry  for  a  worker  who  has  left 
or  is  absent  be  sure  to  put  the  one  who  inquires  in 
touch  with  the  one  who  is  taking  her  place.  If  no 
one  has  been  appointed,  refer  the  inquirer  to  the 
supervisor. 

VOLUNTEERS 

All  names  and  addresses,  telephone  numbers,  hours 
and  days  with  clinics  they  are  serving,  should  be  in 
the  index  file  under  ''Volunteers."  Volunteers  are 
expected  to  register  daily  in  the  general  office,  and  to 
notify  the  supervisor  of  anticipated  absences  or  when 
delayed  in  reaching  the  hospital. 

TELEPHONE 

Messages  taken  over  the  telephone  or  from  a 
visitor  in  the  office  should  be  written  in  the  following 
form  and  put  in  the  letter  box  if  the  mail  has  not  been 
collected  or  on  the  desk  if  it  has. 


FOR  WHOM 


FROM  WHOM  . 


BY  WHOM  TAKEN  . 


TIME  TAKEN  (DATE.  HOUR) 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  73 

Telephone  calls  are  received  by  the  clerk  and 
turned  into  the  worker's  office  by  a  bell  system.  Each 
worker  has  her  own  number  of  rings  posted  on  the 
telephone  and  is  expected  to  listen  for  her  signal. 

When  expecting  a  telephone  call,  notify  the  sec- 
retary where  you  may  be,  otherwise  much  valuable 
time  is  lost. 

In  answering  the  telephone  always  state  at  once 
who  you  are  and  your  connection  with  the  social 
service  department. 

Ascertain  the  name  of  the  person  speaking. 

When  calling  another  agency  find  out  to  whom  you 
are  speaking.  Be  careful  of  the  telephone  you  use 
on  those  cases  when  you  do  not  wish  to  be  overheard. 
Remember  that  patients  sitting  in  the  office  or  near- 
by, may  easily  misinterpret  what  has  been  said  over 
the  telephone  or  feel  that  their  confidences  are  likely 
to  be  betrayed. 

Do  not  use  the  telephone  as  a  form  of  communica- 
tion for  cases  in  which  there  have  already  been  diffi- 
culties or  misunderstandings.  And,  again,  if  during  a 
telephone  conversation  a  misunderstanding  has  been 
created,  do  not  continue,  but  arrange  a  conference  in 
which  to  talk  the  matter  over. 

In  ending  a  telephone  conversation,  reiterate  what- 
ever arrangement  has  been  made;  in  this  way  there 
will  be  no  lack  of  definiteness.  At  this  time  if  you 
are  talking  with  someone  whom  you  do  not  know, 
your  name  may  be  again  emphasized  so  that  further 
communications  on  the  same  case  will  be  made  to  the 
worker  interested. 


74  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 
TELEGRAMS 

Telegrams  if  charged  to  the  hospital  must  be  ap- 
proved by  a  member  of  the  Administrative  Staff  and 
be  sent  from  front  office.  If  prepaid,  they  may  be 
sent  from  the  pay  telephone  booth  in  the  adminis- 
tration building. 

FILING 

All  filing  is  done  by  the  assistant  secretary. 

KEYS 

Keys  to  the  clothes  room,  library  and  supply  closet, 
are  in  possession  of  the  assistant  secretary. 

In  the  supply  closet,  boxes  labeled  to  indicate 
contents  are  arranged  in  order. 

IN  AND  OUT  BOARD 

The  workers  are  to  push  their  names  in  and  out 
whenever  entering  or  leaving  the  hospital. 

OFFICE   RESOURCES 

LIBRARY 

For  the  use  of  the  staff: 
Books  on  social  work. 
Reports  and  reprints. 
Periodicals: 

The  Survey. 

The  Family. 

Hospital  Social  Service. 

The  Public  Health  Nurse. 
For  the  use  of  the  staff  and  patients: 
Fiction. 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  75 

When  a  book,  a  report,  a  reprint,  a  magazine,  etc., 
is  taken  from  the  Hbrary,  the  worker  indicates  on  a 
card  the  title  of  the  volume  and  issue,  the  author's 
name,  the  date  on  which  taken,  signs  her  name,  and 
hands  same  to  the  assistant  secretary.  Books  may 
be  kept  for  two  weeks. 

Books,  reports,  etc.,  are  returned  through  the  as- 
sistant secretary,  so  that  the  card  previously  signed 
may  be  destroyed. 

Fiction  may  be  taken  without  filing  card. 

The  social  workers  have  access  to  the  main  library 
in  the  administration  building. 

Directory: 
Institutions, 
Co-operating  agencies, 
Boarding  houses, 
Interpreters, 
Special  schools, 
Foreign  Consuls. 

USE  OF  SOCIAL  SERVICE  FORD 

The  Social  Service  Ford  is  used  to  bring  patients 
back  and  forth  to  the  dispensary  who  are  not  able  to 
come  by  trolley  and  cannot  afford  to  pay  for  a  taxi. 
We  are  dependent  upon  volunteer  chauffeur  service. 

Workers  wishing  to  requisition  the  Ford,  should 
make  entry  in  register  in  central  office  as  follows: 


DATE 

NAME  OF  PATIENT.  . 

FBOM 

TO 

HOUR 

worker's  initials. 


Entries  should  be  made  as  far  ahead  as  possible  to 
prevent  duplication. 


76  ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE 

CLOTHING   REQUIRED   BY  PATIENTS   EN- 
TERING THE  STATE  TUBERCULOSIS 
SANATORIUM   IN  WINTER 

Horse  blanket 

Rubbers 

Shoes 

Bathrobe 

Bedroom  sHppers  or  bed  socks 

3  pair  hose 

2  sets  underwear  (Hght  or  heavy,  according  to  sea- 
son) 

2  flannelette  night  gowns,  or  2  sets  of  pajamas. 

Cap  (also  muffler,  if  convenient) 

Mittens 

Overcoat 

Laundry  bag 

Hot  water  bottle 

Sweater. 

All  clothing  should  bear  patient's  name  written 
in  indelible  ink. 

Supplies  on  hand  (i.  e.  sputum  cup  and  liners) 
may  be  taken  to  the  Sanatorium. 

These  policies  have  been  gradually  compiled  as  a 
guide  to  the  individual  worker.  The  true  aim  toward 
which  social  service  is  working  has  been  masterfully 
expressed  in  the  words  of  our  Physician-in-Chief, 
Dr.  G.  Canby  Robinson:  "It  should  be  the  outspoken 
ideal  of  every  hospital  and  all  connected  with  it  to 
endeavor  to  have  every  patient  who  enters  its  doors 
leave  the  institution  a  better  man,  woman,  or  child, 
not  only  physically,  but  also  intellectually  and  spirit- 
ually in  the  period  of  transition  when  the  doctor  more 


ORGANIZATION  AND  METHOD  IN  SOCIAL  SERVICE  77 

or  less  withdraws,  the  social  worker  should  take  his 
place,  and  the  transition  should  be  accomplished  with 
intimate  co-operation,  in  that  gradually  the  patient 
is  transferred  from  the  medical  to  the  social  service, 
rather  than  being  discharged  from  the  hospital."   * 

KEY  TO  ABBREVIATIONS 

B  V  H        Bay  View  Hospital  (City  Hospital  and 

Alms  House). 
C  E  of  I      Confidential  Exchange  of  Information. 
H  L  H        Harriet    Lane    Home    (Department    of 

Pediatrics). 
HPPC        Henry  Phipps  Psychiatric  Clinic 
J  H  H         Johns  Hopkins  Hospital 
M  Man. 

M  T  H        Municipal  Tuberculosis  Hospital, 
sec  Supervisors  of  City  Charities. 

S  S  D  Social  Service  Department. 

W  Woman. 


♦"Influence  of  Social  Service  in  The  Hospital."— G.  Canby  Robinson,  M.D.,  Physician- 
in-Chief.  The  Johns  Hopkins  Hospital.  (Pub.  in  HOSPITAL  SOCIAL  SERVICE,  April 
1922— Vol.  v.— No.  4.) 


THIS  BOOK  IS  DUE  ON  THE  LAST  DATE 
STAMPED  BELOW 

AN  INITIAL  FINE  OF  25  CENTS 

WILL  BE  ASSESSED  FOR  FAILURE  TO  RETURN 
THIS  BOOK  ON  THE  DATE  DUE.  THE  PENALTY 
WILL  INCREASE  TO  50  CENTS  ON  THE  FOURTH 
DAY  AND  TO  $1.00  ON  THE  SEVENTH  DAY 
OVERDUE. 


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